Health Care Reform: Who, What, When

Timeline of health care changes

2010


Employers: Small businesses can receive tax credits if purchasing insurance for employees.

Insurers: Cannot impose pre-existing condition exclusions on coverage for children. Must cover preventive services without copays. Cannot remove coverage when a person becomes ill. Cannot impose lifetime coverage limits. Health care reform also regulates annual limits. Insurers must provide an improved way for consumers to appeal health care decisions.

Uninsured: Individuals with pre-existing conditions receive immediate access to coverage through a high-risk pool. Dependent children can remain on parents’ plans until age 26. States will be allowed to cover more people on Medicaid.

Early retirees: Employers were able to participate in a reinsurance program to help provide coverage for retirees and their spouses, surviving spouses and dependents over age 55 and not eligible for Medicare. Due to funding limits, this program stopped reimbursements for claims incurred after Dec. 31, 2011.

Medicare Part D enrollees: A $250 rebate check received for those entering the “donut hole” gap in coverage in 2010. Rebate payable by April 1, 2011.


2011


Insurers: Required to spend at least 80 to 85 percent of premiums on medical services.

Medicare Part D enrollees: Receive a 50 percent discount on brand-name prescription drugs when in donut hole coverage gap.

Health care savings account holders: Federal tax on those who spend health care savings account money on ineligible expenses increases to 20 percent.

Over-the-counter drugs: Except for insulin, OTC drugs without a prescription are not reimbursable from an FSA or HRA, and are not a tax-free reimbursement from an HSA.

W-2: The value of employees’ health coverage must be disclosed on their W-2 forms (optional for 2011 for all employers, large employers must comply in 2012).

Seniors: Certain free preventive services are provided for seniors on Medicare.


2012-2013


Taxpayers: Medicare payroll taxes increase to 2.35 percent for individuals earning more than $200,000 and families earning more than $250,000.

Those with flexible savings accounts: A federal limit of $2,500 for individual pretax contributions per year.


2014


Insurers: Prohibited from refusing to sell or renew policies. Cannot deny coverage for adults with pre-existing conditions. Limits ability to set prices on the basis of sex, health status or other factors. Prohibited from imposing annual limits.

Uninsured: Most Americans required to buy health insurance or pay fines of $95 per individual (or one percent of adjusted taxable income if this amount is greater) and up to $285 per family. Families will pay half the amount for children. Families can receive subsidies to buy insurance if they earn no greater than four times the federal poverty level (about $88,000 per year for a family of four). Individuals and small businesses can buy coverage through state exchanges.


2015


Employers: Companies with 50 or more employees must provide affordable coverage with minimum value or may be subject to a penalty.

Uninsured: Penalties for not carrying insurance increase to $325 per individual (or two percent of adjusted taxable income if this is greater) and up to $975 per family. Families will pay half the amount for children.


2016


Uninsured: Penalties for not carrying insurance increase to $695 per individual (or 2.5 percent of adjusted taxable income if this is greater) and up to $2,250 per family. Families will pay half the amount for children.


2018

Taxpayers: A 40 percent excise tax imposed on high-cost employer-provided policies ($10,200 for individual coverage or $27,500 for family coverage).

2020

Medicare Part D Enrollees: Prescription drug coverage gap eliminated.


Source: www.healthcare.gov